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Optional Assessments Lead to Better Diagnoses, Improved Recovery

By Leslie Davis

When patients are initially admitted for residential treatment at Sierra Tucson, they undergo routine tests to assess depression, hopelessness, and suicidal thoughts. These tests are administered in order to create a better treatment plan for each patient and to create a safe environment.

Once a patient has adjusted to life at Sierra Tucson, several other tests may be administered per a doctor's order. These tests, which can enhance the ability of Sierra Tucson's medical team to diagnose and treat all issues that are impacting the client, may including the following:

• Personality Tests, which look for major psychiatric conditions and personality styles. This is the most common test, and can help confirm or disconfirm a diagnosis.
• Intelligence Tests, which determine a patient's intellectual ability and IQ.
• Cognitive Tests, which look at a patient's capacity for attention, concentration, reasoning, memory, spatial processing, and reaction time. This helps determine a patient's cognitive ability to benefit from treatment.
• Career Testing to determine a patient's aptitudes and interests. This is most commonly used with patients who are considering a career change or with younger patients who have yet to select a career path.
• Standardized Testing to help determine if a patient suffers from disorders such as eating disorders, obsessive-compulsive disorder, or dissociative disorder. These tests can determine the presence, nature, and severity of such disorders.

"Our patients report that they really benefit from our assessments," said Andrew Stropko, Ph.D., Director of Psychology at Sierra Tucson. "Patients say the tests are very helpful and give a lot of insight into their personality and how it interacts with their conditions."

When Tests are Administered

The additional assessment tests are generally not given until a patient has spent a bit of time acclimating to Sierra Tucson. "We give patients time to settle in, get beyond the noise of what brought them to treatment, and let them adjust to their new setting," Stropko said.

There are several benefits to waiting until a patient is settled to administer the assessment tests:

• It allows the patient to be more focused on the testing.
• The patient is less likely to be distracted by the events that brought him or her to the treatment center, or by the adjustment process.
• It gives time for the detoxification process to be completed.
• It allows for any changes in medication to take effect.

Stropko estimates that about 93 percent of the patients at Sierra Tucson are administered assessments beyond those given at admission. Patients undergo the additional tests either because the treating doctor wants to confirm a diagnosis or shed light on some questions, or because patients request the testing to learn more about themselves and their disorder.

"Patients really enjoy the testing process," Stropko said. "They enjoy learning about themselves, and it makes recovery more meaningful."

Many of the tests identify areas where a patient may need accommodations or special help. For example, the testing may discover that a patient has poor verbal skills and would do better using sketching or drawing to complete assignments. The testing helps therapists determine what types of treatment modalities are most likely to be successful with the patient.

The Testing Process

The time it takes to complete each test ranges from 40 minutes to two hours. Tests are either completed on a patient's own time or are administered by staff in the Psychology Department.

Within a couple of days of taking a test, the patient is given the results, as well as any feedback that is necessary for them to understand and contextualize this information. The results are provided to the treatment team, which includes the unit therapist and primary medical provider.

Patients are typically given each assessment only once. However, a test can be repeated if it was determined to be invalid due to such factors as stress, the patient feeling overwhelmed, or an unclear diagnosis, Stropko said. If a test was given to a patient too soon after admission, it may be repeated for clarity.

A patient who has a significant chemical dependency problem is usually given the tests again after six months in recovery.

"The initial test is used as a baseline, and there may be a more accurate picture in recovery," Stropko said. "Significant chemical dependency can also cloud the findings in testing and interviews."

Stropko, who began working at Sierra Tucson in 1992, said the center's testing process has remained standard over the past 17 years, although new versions of tests are incorporated. The biggest change he has seen is an increased use of computers to administer, scan, and score many of the tests.

"It makes the results more accurate," he said. "There are fewer mistakes, and it saves a lot of professional time."

With the addition of Sierra Tucson's SPECT scanning in 2009, Stropko has seen dramatic results. "It has been exciting, in a multidisciplinary setting," he stated, "to compare results from psychological testing to results from SPECT scans and view how these findings complement each other to better understand a patient."